In 1978, I was lying back with my ophthalmologist peering into my eyes with his blinding miner’s lamp. He shut it off and called a colleague into the exam room. They spoke medical talk above me for a while until I asked “Fellas, what is it?”
My doctor said, “It’s nothing to worry about, when can you check into a hospital?” I had a semi-detached retina in my right eye. On the day of my surgery, a nurse administered sedation and the last thing I heard before I lost consciousness was the surgeon saying, “Which eye was it again?”
Several Democratic candidates for the 2020 presidential nomination have been advocating “Medicare for all” thus ending private insurance in the United States. According to the US Census Bureau, 56 percent of Americans receive insurance coverage through their employer; an additional 16 percent buy coverage independently; 19.3 percent are on Medicaid (the program for the poor) and 17.2 percent have Medicare (the program for the elderly).
The figures add up to more than 100 percent because people shift back and forth between types of coverage during the year. For instance, a person may have insurance through their employer and then lose or change jobs resulting in a different kind of coverage during the same year.
Approximately 2.66 million Americans are employed by the insurance industry and while some of those jobs would remain (auto and life insurance for example) many would disappear in a Medicare for all scenario. Advocates of “Medicare for all” argue that this takeover of health care would save money through the elimination of bureaucracy, cutting out the insurance middleman as well as through the bargaining power of the government to negotiate lower prices. That may turn out to be true but it hasn’t so far in other countries, depending on which health services one examines.
According to the study International Comparisons of Waiting Times in Healthcare printed in Health Policy, median wait times for elective surgeries in countries with nationalized medicine are horrendous.
In Canada, the wait times are 48-178 months depending on which province you’re waiting in. In France the wait time is 33 months, in England 35 months, in Denmark 38 months, in Portugal 86 months and so on.
According to the Nuffield Trust, a health care think tank in Britain, patients wait an average of 64 minutes before being treated in emergency rooms in England but that’s after people have often already waited, sometimes for hours, outside in an ambulance because the clock doesn’t actually start until the patient hits the waiting room.
The National Health Service, which covers 66 million British people, costs 160 billion US dollars in taxpayer money and an additional almost 17 billion dollars in private expenditures (usually to pay for quicker or “uncovered” services like chiropractic).
The Committee for a Responsible Budget projects that Medicare for all would cost between $28 billion to $32 billion over 10 years, a study called The Cost of a National Single Payer Healthcare System conducted by George Mason University projects that the U.S. will spend $59.4 billion on health care under Medicare for all (2022-2031), which would be $32.6 billion more than the U.S. would otherwise spend on just Medicare and Medicaid during the same period.
Allowing people to buy into Medicare at age 55 makes better sense. It would bring in additional, potentially healthier, people into the program producing a more viable financial arrangement long term. That also may encourage older folks to get out of full time occupations earlier thus opening up opportunities for younger workers seeking employment. A limited expansion of Medicare would avoid systemic disruptions, long wait times and the other negative consequences of completely revolutionizing health care, which is 17.9 percent of our total economy.
Thankfully, the surgery was performed on the correct eye. However, my hospital roommate was allergic to eggs. We traded daily, his eggs for my oatmeal. Do we really think the government would do better?